NYS SOciety of ORTHOPAEDIC Surgeons

NYS Department of Health Commissioner Dr. Howard Zucker released the following statement regarding the Johnson & Johnson vaccine:

"Today the CDC and FDA issued a statement recommending a pause in the use of the Johnson & Johnson vaccine out of an abundance of caution. New York State will follow the CDC and FDA recommendation and pause the use of the Johnson & Johnson vaccine statewide immediately today while these health and safety agencies evaluate next steps. All appointments for Johnson & Johnson vaccines today at New York State mass vaccination sites will be honored with the Pfizer vaccine.

"As the CDC and FDA have said, any adverse events related to the Johnson & Johnson vaccine 'appear to be extremely rare' and, 'People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.'

"I am in constant contact with the federal government and we will update New Yorkers as more information becomes available."

OrthoInfo, the AAOS patient education website, is a free member resource that provides orthopaedic surgeons and patients with authoritative, in-depth information about musculoskeletal health.

The website features more than 400 articles, videos, and animations on common orthopaedic problems, surgical procedures, nonsurgical treatments, injury prevention, and healthy living.

All content is developed and peer reviewed by AAOS members. Written in simple language, OrthoInfo articles can help your patients be better informed and participate more fully in their care and recovery.

Access the site

The year 2021 marks a historic change in the coding world for outpatient office visits, with the first major revision to the CPT evaluation and management (E/M) codes in more than 20 years taking effect. Learn more: https://www.aaos.org/aaosnow/2021/feb/managing/managing01/

NYSSOS is proud to share this article from Ariana Lott, MD a resident at NYU Langone! She partnered with Drs. Weiss, Baker and Kim to explore the need for formal training on communication with patients.

Patient-physician communication skills have always been important for orthopaedic surgeons in providing patient-centered care. Although communication is important, orthopaedic surgeons have little formal training on how to communicate with patients. Compared to the countless hours dedicated to surgical training, there is little direct observation of orthopaedic resident and fellow communication skills. This lack of training is demonstrated in the literature, as orthopaedic surgeons ranked last out of 28 specialties with respect to patient-reported communication skills.

Studies have demonstrated that with improved communication, there is higher patient satisfaction, increased compliance with proposed treatments, and overall improved outcomes. In an analysis in the outpatient setting, physician empathy was found to be the strongest driver of patient satisfaction. Communication skills are particularly important for surgeons because establishing trust with patients presenting for surgical evaluation is essential. For true shared decision making, it is imperative that surgeons are able to communicate clearly so patients understand their diagnosis and treatment options for their specific medical conditions. Improved communication and trust also correlate with decreased medical-legal liability.

> Read the entire article

This week the AAOS and the New York State Society of Orthopaedic Surgeons (NYSSOS) joined with other physician organizations in encouraging state legislative leaders to embrace a proposal for reducing medical liability costs. Specifically, the measure tucked into Governor Cuomo’s Executive Budget proposal would provide much-needed relief to medical professionals in the form of lower liability insurance premiums and litigation costs. The organizations pointed out that a significant impediment to an already challenged industry is a dysfunctional medical liability adjudication system that is increasing costs at a time when medical practices are already operating amidst heightened financial stress as a result of COVID-19. The stark reality is evident in New York, where physicians and hospitals endure the highest liability awards and costs. A recent report indicated that in 2019, New York had the greatest total medical liability payouts of any state and nearly 70% more than the state with the second greatest amount. AAOS believes that the structure of the current medical liability system limits the ability of physicians to provide the highest quality patient care and that systemic reform is necessary to improve the overall health care system. Read the full letter... 

Recently enacted legislation has removed the McCarran-Ferguson Act, an antitrust exemption that has protected insurers since 1945. Insurers will now be required to follow the same free-market rules as the other industries. On an episode of AAOS’ advocacy podcast “The Bone Beat,” George Slover, senior policy counsel for Consumer Reports, discusses why this repeal took so long and how the new law will introduce more choice and opportunity into the marketplace. > Listen in

During these unprecedented times, a significant focus has been placed on implementation and integration of telemedicine within the traditional framework of in-person orthopaedic practice. Although the growth of telemedicine was expected previously, the COVID-19 pandemic has rapidly accelerated its widespread implementation. Recent publications have focused on pre-visit technical considerations, including obtaining requisite equipment and fostering pathways for viewing imaging studies. There remains a dearth of orthopaedic literature reporting on the prevalence of adverse events encountered in the setting of virtual visits. This lack of information presents a patient safety concern that must be addressed before telemedicine is considered a mainstay of everyday practice.

Defining such red flags is essential for a successful telemedicine program, given that a major disadvantage of telemedicine is the limited physical exam. Although surrogate examination maneuvers have been described for the upper extremity (pushing oneself up from a chair) and lower extremity (hopping in place on the involved leg) to conform to the video format, they may not be specific enough for particular diagnoses. Conditions that can potentially be missed because of a lack of in-person interaction include: > Read article

On Monday, February 8th, NYSSOS issued a memorandum in opposition to A273 (Gottfried) which Requires a practitioner to consider and prescribe non-opioid treatment alternatives for treatment of neuromusculoskeletal conditions.

NYSSOS stated the following:

The Society agrees that physicians should be looking at non-opioid alternatives to analgesia and work within the patient encounter to consider alternatives available before choosing an opioid prescription.  However, legislating medical treatment or guidelines interferes with the doctor patient relationship. Advancing this type of legislation will negate the physician's expertise regarding treatment for neuromuscular problems. Mandating provisions like this will supersede the existing training and measures to reduce inappropriate prescribing of opioids. Going forward, physicians, public health officials, policymakers and health insurance companies must work together to take meaningful action and create an integrated approach to combat the opioid epidemic. Legislating a medical encounter will not achieve the shared goals of improving care to patients and supporting a sustainable, predictable and resilient public health system.

 The opioid crisis is real, and steps are being taken within the profession to address it.  Programs like ISTOP, although cumbersome as it was being set up, has helped prescribers to identify drug seeking patients and control prescribing.  We do not agree with the principle to institute mandates of this nature which restrict a licensed physician from making decisions based upon their medical training and in their best judgement. This bill will limit the ability to appropriately treat patients in pain and can lead to additional liability.  As such we are in opposition.

To see a copy of the full memo - please email bgrey@nyssos.org

Amid the COVID-19 pandemic, social media allows us to stay connected to loved ones. Beyond that, physicians have begun using social media platforms as tools in their practices—from offering medical information to the public to highlighting career achievements, social media has become personal marketing tools for the 21st-century doctor. With that in mind, this article provides five helpful tips for using social media as a part of your orthopaedic practice.

> Read the complete article

The next chapter in the modernization of the New York State Workers’ Compensation Board, the OnBoard Project, is well underway. The Board, with its integration partner CapTech Consulting, is building a new claims system that will replace the multiple legacy, paper-based claims systems, such as CIS and eCase, with a single, web-based platform.

The new system will offer improved and expanded access to real-time claim data, new electronic self-service features for interacting with the Board, and a reduction in the amount of overall paper forms to improve system responsiveness to stakeholder needs.

To learn more please visit: http://www.wcb.ny.gov/onboard/